Related Experiment Video
Updated: Aug 6, 2025
Testing Targeted Therapies in Cancer using Structural DNA Alteration Analysis and Patient-Derived Xenografts
Published on: July 25, 2020
RAPID framework for improved access to precision oncology for lethal disease: Results from a modified multi-round
Kristin Bright1,2, Anneliese Mills3, John-Peter Bradford4
1Department of Anthropology, Middlebury College, Middlebury, VT, United States.
Introduction:
Predictive oncology, germline technologies, and adaptive seamless trials are promising advances in the treatment of lethal cancers. Yet, access to these therapies is stymied by costly research, regulatory barriers, and structural inequalities worsened by the COVID-19 pandemic.
Methods:
To address the need for a comprehensive strategy for rapid and more equitable access to breakthrough therapies for lethal cancers, we conducted a modified multi-round Delphi study with 70 experts in oncology, clinical trials, legal and regulatory processes, patient advocacy, ethics, drug development, and health policy in Canada, Europe, and the US. Semi-structured ethnographic interviews (n = 33) were used to identify issues and solutions that participants subsequently evaluated in a survey (n = 47). Survey and interview data were co-analyzed to refine topics for an in-person roundtable where recommendations for system change were deliberated and drafted by 26 participants.
Results:
Participants emphasized major issues in patient access to novel therapeutics including burdens of time, cost, and transportation required to complete eligibility requirements or to participate in trials. Only 12% of respondents reported satisfaction with current research systems, with "patient access to trials" and "delays in study approval" the topmost concerns.
Conclusion:
Experts agree that an equity-centered precision oncology communication model should be developed to improve access to adaptive seamless trials, eligibility reforms, and just-in-time trial activation. International advocacy groups are a key mobilizer of patient trust and should be involved at every stage of research and therapy approval. Our results also show that governments can promote better and faster access to life-saving therapeutics by engaging researchers and payors in an ecosystem approach that responds to the unique clinical, structural, temporal, and risk-benefit situations that patients with life-threatening cancers confront.
Insights
Improving access to advanced cancer therapies requires addressing research costs, regulatory hurdles, and inequalities. Experts recommend an equity-centered model and government-industry collaboration for faster, fairer patient access to novel treatments.
Area of Science:
- Oncology
- Clinical Trials
- Health Policy
Background:
- Predictive oncology, germline technologies, and adaptive seamless trials offer promising advances for lethal cancers.
- Access to these breakthrough therapies is significantly limited by high research costs, regulatory barriers, and systemic inequalities, exacerbated by the COVID-19 pandemic.
Purpose of the Study:
- To develop a comprehensive strategy for rapid and equitable patient access to novel cancer therapies.
- To identify and address systemic barriers hindering access to cutting-edge cancer treatments and clinical trials.
Main Methods:
- A modified multi-round Delphi study involving 70 experts across oncology, clinical trials, regulatory affairs, patient advocacy, ethics, drug development, and health policy in Canada, Europe, and the US.
- Semi-structured ethnographic interviews (n=33) were conducted to identify key issues and potential solutions.
- Survey data (n=47) and interview findings were co-analyzed, followed by an in-person roundtable (26 participants) to draft system-change recommendations.
Main Results:
- Experts highlighted significant patient access burdens related to time, cost, and transportation for trial eligibility and participation.
- Only 12% of respondents expressed satisfaction with current research systems.
- Top concerns identified were "patient access to trials" and "delays in study approval."
Conclusions:
- An equity-centered precision oncology communication model is essential for improving access to adaptive seamless trials and reforming eligibility criteria.
- Involving international advocacy groups is crucial for building patient trust and ensuring representation throughout research and therapy approval processes.
- Governments, researchers, and payors must collaborate in an ecosystem approach to facilitate faster, equitable access to life-saving cancer therapeutics, considering individual patient circumstances.
More Related Videos
13:24Integration of Wet and Dry Bench Processes Optimizes Targeted Next-generation Sequencing of Low-quality and Low-quantity Tumor Biopsies
Published on: April 11, 2016
08:52Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids
Published on: November 22, 2021
Related Concept Videos
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...